Opioid is America’s number one killer, surpassing death by guns and car crashes.

In the late 1990s, pharmaceutical corporations promoted prescription opiates as the solution to America’s physical pain. Americans begin taking the drug, without realising they would soon start getting hooked on it. Because of the epidemic, the US government came up with a clear solution – restricting opiates prescription and preventing addicts from taking them – with hopes to resolve the issue, or so they thought.

However, drugs have increased over the years, making America the world’s leader in opioid prescriptions. In 2016, the US recorded a new number in the deaths by opioids – with 64,000 people died of drug overdoses, trailing back to the use of synthetic opioids (such as fentanyl), heroin, and common opioid painkillers (e.g. Percocet and OxyContin).

The Centre for Disease Control and Prevention (CDC) reported opioids as the number one contributor, in comparison to other types of drug overdose. The number makes opioids death toll higher than those of guns, car crashes and HIV in the US.

Healthcare professionals contributed to the epidemic

Wall Street Journal reported that doctors prescribing painkillers has led to drug dependence and addiction. University of Michigan researchers found that about one in every 16 surgical patients who were prescribed opioids were still getting the drugs three to six months later. On the contrary, approximately 54% of people who misused prescription opioids claim they obtained them from a friend or relative (who have prescribed painkillers) — either with or without that person’s knowledge.

Another study found that dentists prescribe opioids at a rate higher than nearly every other specialty, responsible for writing one out of every eight prescriptions for immediate-release opioids in the US.

Study revealed dentist is responsible for writing one out of every eight prescriptions for immediate-release opioids in the US.

As a way to reverse the problem, Wall Street Journal suggested that doctors should review the quantity they prescribe. Researchers from Dartmouth Hitchcock Medical Centre reported that 15 pills would effectively manage most patients’ pain following laparoscopic gall bladder removal. However, some patients were prescribed as many as 100.

Online sellers’ takeover

Training doctors would be possible, but even though doctors stop prescribing once deem there’s no need for medication. Nonetheless, patients who are already accustomed to the drug are still able to get the medication online. Domestic RCs (DRC), an online company selling compounds that have never been approved for human use enables online medication purchasing as an alternative to doctors and dealers. A pre-admission disclaimer on the company’s website says that all products it sells “are for the purposes of research only”.

The existence of an online drugstore makes it easier to purchase painkillers as it requires no insurance card or physical examination. It is also safer than dealers where patients might be threatened. Drugs like benzodiazepines can be bought as liquids, pills, powders, and pellets of substances with names that sounded like real drugs — clonazolam, diclazepam, etizolam, and flubromazolam — but weren’t.

Government’s involvement urged to address “one nation overdosed”

To curb the problem, Chris Christie, governor of New Jersey urged for a state of emergency to push Trump administration to take the steps that are needed to combat the crisis of overdoses, as well as force Congress to take the matter seriously.

“It would also awaken every American to this simple fact: if this scourge has not found you or your family yet, without bold action by everyone, it soon will,” the report says.

The report presented July this year calls for states to be allowed to grant waivers to existing Medicaid exclusions that currently put the burden of caring for people with substance abuse problems wholly on to state budgets. It also proposed that the CDC should produce a new set of training standards and guidelines for clinicians on the safe dispensing of drugs.

A lesson from Swiss

When Switzerland was facing the Opiate epidemic, they assigned addicted people to clinics where they were given opiates under supervision by a nurse. Patients were also given extensive social support to turn their lives around, including therapy and help in finding a job or housing. Patients were given the drug but at the same time, workers dealt with the cause of the problem that made patients relied on the drugs in the first place.

There is no time limit as to how long patients can stay; but, almost everyone chooses to stop after a few years. Since the programme began, there have been zero overdose deaths on legal opiates in Switzerland. MIMS

At the recent Malaysian Community Pharmacy Business Forum (MyCPBF), a discussion forum was held on the subject of “Transcending Primary Healthcare Services: The Future of Specialized Pharmacy Services and Pharmacy Specialization”.